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12. What business equipment will be used to process this form? (Describe type, make and model.) <br />13. How will the form be referenced? <br />❑' Name ❑ Case/file4 ❑ SSN# ❑ I.D.# ❑ Other, describe <br />14. Where will the information be filed/stored? <br />15. How will the form be filed? <br />❑ Std. 8 1/2 x 11 file ❑ Legal file ❑ Tape/Disc ❑ Other, describe <br />16. Will the data be keypunched? ❑ No ❑ Yes <br />IT How many copies of the form will be needed (1, 2 or 3 -part form) and where does each part go? <br />18. How long must the information be kept? (Cite statute or law.) <br />19. How many forms will be used in: 6 months I year <br />20. Is the information/form on a Records Retention Schedule? ❑ No ❑ Yes <br />21. Prepare and attach a forms flow chart. <br />Operation Transport Store Delay Inspect <br />*Denotes elements which comprise the "Data Practices Annual Report" <br />CAH50884 <br />GA115-26 2 <br />